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The Efficacy of an Urban Farm Intervention Based on the Stages of Change for a Low Income Population with Multiple Risk Factors for Diabetes
Author(s) -
Clare Rachel A.,
Jenkins James,
Humphries Debbie
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.313.5
Subject(s) - environmental health , medicine , overweight , behavior change , nutrition education , gerontology , anthropometry , population , poverty , consumption (sociology) , baseline (sea) , obesity , economics , social science , oceanography , pathology , sociology , geology , economic growth
Background Obesity and chronic disease are highly prevalent in the United States, and adherence to dietary practices that decrease risk is low. Innovative approaches to addressing social, behavioral, and nutritional risk factors are crucially needed. The New Haven Farms' Farm‐Based Wellness program (FBWP) is an innovative approach, which provides regular exposure to and participation in urban agriculture with an aim of increasing fruit and vegetable consumption and decreasing diabetes risk factors. Objective To evaluate the FBWP's effect on participants' perceived and actual stages of change, fruit and vegetable consumption, and the relationship between consumption and the stages of change before and after program completion. Methods Program participants are recruited from neighborhood community health centers in New Haven, CT and must have at least two diabetes risk factors and income within 200% of the 2010 U.S. poverty line. Participants attend a sixteen‐week on‐farm program integrating farm work, cooking and nutrition education, and receipt of a weekly share of vegetables and some fruits. Participants complete a baseline, weekly and closing assessment that includes anthropometry, blood pressure, household and personal characteristics, the stages of change questionnaire (Lechner, et al.) and a national validated dietary screener to estimate fruit and vegetable intake (NHANES Dietary Screener). Results 73 participants completed the baseline assessment in 2016, 90 attended at least one weekly session, and 30 completed both the baseline and the final assessment, as well as attending some weekly sessions. At baseline, 22.0% were in precontemplation and contemplation, 70.4% were ready for change, and 7.4% already consumed a mean of 2.6 servings of vegetables per day. For fruit, 25.9% were in precontemplation and contemplation, 51.9% were ready for change, and 18.5% already consumed a mean of 2.8 servings of fruit per day. The mean daily combined fruit and vegetable intake was 3.1 servings both for those who only completed the baseline survey as well as for the 30 participants with baseline and final data. Among the 30 participants with complete data, after program completion daily vegetable servings increased to an average of 2.1 daily servings (p=0.008) and daily fruit servings decreased to 1.5 daily servings. Initial stage of change was associated with an increase in vegetable consumption (p= 0.087), but not in fruit consumption (p=0.658). Individuals in the action/maintenance stage increased vegetable intake an average of 1.4 servings per day, in preparation increased an average of 0.6 servings per day, and in precontemplation decreased an average −0.1 servings per day. Conclusions These findings suggest that targeting of the program to individuals in a specific stage of change might increase the overall impact of the program. The FBWP may benefit from integration of behavior change models in programming.